This is a Computerized Tomographic (CT) image of a patient with a fractured cheek bone. As a craniofacial surgeon at a major medical center, I have treated hundreds of these injuries. Facial fractures may result from any significant blunt trauma -- motor vehicle accidents, physical altercations, sports injuries. Facial fractures may be isolated injuries, but are often associated with more significant head, torso and extremity injuries. It all depends on the mechanism of injury.
In the last year I have witnessed a new injury demographic, amounting to almost an epidemic: bicyclists over the age of 50. Whereas I used to treat older patients with bicycle accident injuries once or twice a year, just last week I evaluated three!
Young and old are encouraged to ride bikes in Boston. Mass.gov recommends biking as an alternative commute option that saves the public money on gas and helps promote a healthy lifestyle.
According to the City of Boston website, bicycle ridership increased by 122 percent from 2007 to 2009. Bike lanes have been instituted on two of the city's major streets, Massachusetts and Commonwealth Avenues, now the two city streets with the highest incidents of bike accidents. Bike accidents on busy streets are predictable since bicycles provide no protection to the rider and poor maneuverability. My daily observation tells me that bicyclists (young and old) while slowing motor vehicle traffic on Commonwealth Avenue rarely stop for red lights or stop signs, frequently ride outside of the bike lane and often ride on the wrong side of the street.
People over 50 have slower reflexes, less strength, less coordination, less aerobic capacity and lower bone density. (See "Exercise and Aging: Can You Walk Away from Father Time?" in the December 2005 issue of the Harvard Men's Health Watch. For more information or to order, please go to www.health.harvard.edu/mens.)
These unfortunate realities make older riders less likely to avoid a bike accident -- and if they have one, it's more likely to be severe. Presumed superior intelligence, good judgment and decision making are not protective from bike accidents and injury. U.S. Supreme Court Justice Stephen Breyer (born in 1938) suffered a broken collarbone in a bike accident while riding near his home in Cambridge this summer. In 1993, he suffered a punctured lung and broken ribs when he was hit by a car while cycling across Harvard Square.
While being dangerous, city bike riding also has a limited exercise benefit. If you weigh 150 lbs and walk two miles to work at four miles/hour you will burn 150 calories. If you ride your bike that distance at 10 miles/hour, you will only burn 75 calories.
If you are over 50, think twice before you get on a bicycle, especially if you plan on riding in busy traffic. The benefits just don't outweigh the potential consequences.
Follow Michael Yaremchuk, M.D. on Twitter: www.twitter.com/@DrYaremchuk
Kevin Powell: Mayor Bloomberg, New York Police, and Bicycles
"While being dangerous, city bike riding also has a limited exercise benefit."
First, there's zero evidence from this article - or anywhere else - that biking in a city is dangerous. Dangerous, Dr., compared to what? Sitting in a rocking chair? Slicing onions? Skydiving? Rock climbing? Glue sniffing?
Second, come for a ride with me in my city, Los Angeles, and we'll see if there's any exercise benefit. We'll do repeat sprints between stop signs and stop lights, and then cruise up and down a few hills with 10% grades.
Finally, concerning this: "Whereas I used to treat older patients with bicycle accident injuries once or twice a year, just last week I evaluated three!"
You yourself wrote that the numbers of cyclists are increasing. Thus no surprise in an increase of injuries. Three injuries last week? That hardly constitutes an epidemic of injuring - let's see the figures for the past three months, six months, one year.
http://www.commutebybike.com/2011/08/17/cycling-over-50-the-benefits-just-dont-outweigh-the-potential-consequences/
So what are the risks associated with driving in Boston or not exercising for 20 years? I recently heard that watching television six hours a day will shorten your life 5 years (http://www.huffingtonpost.com/2011/08/17/1-hour-of-tv-lifespan-22-minutes_n_929321.html)
What is the transfer rate of injury from people who switched from driving to biking?
Most people won't bike a distance they could have easily walked. On average someone biking is probably traveling a farther distance than someone walking.
Perhaps you should request that the City of Boston make better accommodations for cyclists on its roads.
You really need to take a class on systems thinking and one one regression analysis.
Harvard '03
Oh, your link to the claim that cycling two miles only burns 75 calories is broken.
I would venture a guess that younger riders have a greater rate of injury than older riders due to their tendency to ride faster, ride more miles, and take more risks. Any increase in craniofacial injuries among older riders can be attributed to factors not considered by the author - such as the experience and skill level of the injured older riders. An increase in the total number of older riders may represent an increase in the number of inexperienced riders, who are more likely to suffer accidents and injuries than their more experienced counterparts.
As far as the author's conclusion about there being fewer health benefits from cycling than risks, this is the sort of comment made by someone unfamiliar with cycling. Even in city traffic, cycling has cardiovascular benefits. More importantly, cycling helps older cyclists to maintain muscle mass, which is lost with aging. This helps with balance and the retention of independence with increasing age. Cycling is also one of the best exercises for osteoarthritic knees (a common condition among older adults). It is low impact, yet strengthens leg muscles - particularly the quadriceps - to help support and protect the knees. Cyclists should assess their fitness and skill levels - rather than using age - to determine whether cycling's benefits outweigh its risks.
Where do I start?
1) You don't have to bike in the city - you can ride on less trafficked roads or bike trails. At the very least, you could have been more specific about your warning.
2) A two-mile bike ride will only take 8 - 12 minutes, so even if it doesn't burn that many calories, it still elevates the heart rate, exchanges air in the lungs, and carries oxygenated blood to body cells. There is more benefit to exercise than simple thermodynamics.
3) Bicycling is low impact, so it's easier on joints than walking or running.
4) Bicycling can help improve coordination, strengthen muscles, and quicken reflexes.
5) I could go on and on, but cautioning someone over 50 NOT to exercise with one of the best cardiovascular exercise products available because they MIGHT wipe out or get hit by a car is like telling an overweight patient not to eat cruciferous vegetables because they might choke...
A safe cyclist wearing a helmet and gloves, riding cautiously and defensively, obeying the rules of the road will still be no safer than the drivers around him. Maybe you should use your position to help encourage a "share the road" message while encouraging cyclists to ride safely...